Hourly Rounding with purpose: Evidence Based Practice Project

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					      3ed International Nursing Conference-2010
           Jordanian Nursing Council JNC




Hourly Rounding with purpose: Evidence
        Based Practice Project


       Mohammad R. Al-Qudimat, RN, MSN
    Nursing Research & Evidence Based Practice
               Program Supervisor
King Hussein Cancer Center - Department of Nursing
                 Outline
Background
Aims
Methodology
– PICO Question
– Searching Key Words
– Search Data Base
Result and discussion
Recommendation
Acknowledgments
Conclusion
            Background

What is hourly round project?
 It is the deliberate action of nursing staff
 visiting patient on a pre-determined time
 schedule to ensure that care needs are met
 through proactive nursing intervention.

 Hourly rounds are systematic nursing bedside
 rounds that incorporate specific actions, done
 at specific intervals (McCartney, 2009)
               Background
Reason for change
1. Research shows that hourly patient
  rounding:
   Increases patient satisfaction.
   Decrease call light usage
   Increase patient safety  hospital-acquired
    pressure ulcers, and falls
2. Support our goal  nursing care
3. Standard for customer services
   Reactive response  Proactive response
             Background
Many nurses revealed that they are
already performing routine rounding on
their patients, responding to call light, and
tried their best to improve patient safety.

Frequent responses to call lights interrupt
continuity of care and actually may
decrease patient satisfaction (Gurney,
2006).
                Purpose

The purposes of this project
   To investigate best practice interventions
   to increase patient safety, patient
   Satisfaction and decrease call light at
   King Hussein Cancer Center.
   To report the best evidences and
   implementation of the hourly rounding
   practice.
Methodology – Task force team
Task force team was assigned
 – Nursing research and EBP supervisor
 – Magnet project supervisor
 – 4 clinical supervisor


Evidence Based-Resource Unit Nurses 
take care of the application in units
Methodology - PICO Question
Among oncology patient, is the nursing
hourly rounding with purpose improve the
patient safety and satisfaction in
comparison to the current routine practice
at KHCC?
  Methodology – Data Base
A literature search was conducted using
– PubMed
– Ovid
– Science Direct
– EBSCOhost Databases
    Methodology – Key word
hourly round           nursing round and EBP
nursing round          call light quit
24hourly round         fall prevention
call light             improve patient safety
falling down           patient safety
patient satisfaction
effect of round
Methodology – Review of literatures
  The literature found was published
  between 1994-2009
  A total of 50 articles containing original
  research, and expert opinion, were
  included in the review.
  23 articles that related specifically to
  hourly rounding were found.
  All evidences revealed that hourly
  rounding decreased patients' fall, bed-
  sore, and increase patients' satisfaction.
Methodology – Review of literatures
 EB-RUN program preprinted Summary
 table was used for research critiques

 The level of evidences was between III-
 VII.
  – Level of evidence from Research studies or other sources**
Methodology – Result and Discussion
   All relevant literatures concluded that
   the rounding with purpose:
  –   Decrease falling down events (references)
  –   Decrease pressure ulcer (references)
  –   Improve patients satisfaction (references)
  –   Organize nurses time  hourly rounding
      can save hospital nurses an estimated 166
      hours a month (studer group, 2006 & Trinsey,
      2006)
           What did we do?
1. Form the team
2. Literature review
3. Data collection
4. Presentation to nursing leaders
5. Preparation phase: Kick-in day
6. Hands on practice for all involved KHCC
   nurses
7. Implementation phase
8. Data collection after the implementation
              Our team
Task force team was assigned
– Nursing research and EBP supervisor
– Magnet project supervisor
– 4 clinical supervisor


Evidence Based-Resource Unit Nurses 
take care of the application in units
           What did we do?
1. Form the team
2. Literature review
3. Data collection
4. Presentation to nursing leaders
5. Preparation phase: Kick-in day
6. Hands on practice for all involved KHCC
   nurses
7. Roll up
8. Implementation phase
9. Data collection after the implementation
    Kick-in day two days
Photo
           What did we do?
1. Form the team
2. Literature review
3. Data collection
4. Presentation to nursing leaders
5. Preparation phase: Kick-in day
6. Hands on practice for all involved KHCC
   nurses
7. Roll up
8. Implementation phase
9. Data collection after the implementation
        Roll up
Photo
        Our Slogan


“Its not how much time you
spend…it’s how you spend
          the time”

                 Author unknown
What did we do? Rounding charter
Assigned RNs are responsible for rounding on
their patients, they could be partner with
PN/LPN to ensure round effectiveness
Rounds will be done every hour from 6:00-
22:00 and every 2 hour 22:00-6:00
A 24 hour rounding sheet shall be posted in a
prominent place at the bedside for each patient
document rounding/action on the 24 hour
rounding sheet immediately after the round
What did we do? Rounding charter
The 5 Ps will be addressed on each round:
P: Pain  pain level + pain management
P: Potty  offer toileting assistance + empty urine
P: Position  assess comfort position
P: Personal equipment;
    i.e. Call light, Telephone, TV remote control,
    Water, Trash can, empty urinal, and Tissue box.
P: Promise to return back;
   – some one will be back in one hour to round on
      you again.
What did we do? Rounding charter




“I am here to do my round because I
               care!”
What did we do? Rounding charter



"Is there any thing that I can do for
  you before I leave? I have the
              time."
        Peer supporter
Nursing leaders
Magnet and EBP
Educator
             Conclusion
We believe that changing practice based
on best evidences will be reflected
significantly on direct patient care.
The evidences recommend using the
hourly nursing round to enhance patient
safety, satisfaction, and decrease the
workload on nurses.
Despite challenges to initiate change into
the work flow, the best evidences
recommend the hourly rounding as
standard of care.
    ACKNOWLEDGMENT
Bedside Nurses
Nursing Leaders
Thank You

				
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posted:11/29/2011
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